Estimating the effect of the Prometheus payment model on total spending and provider revenue

The Robert Wood Johnson Foundation has funded the development and implementation of a series of pilots to examine the feasibility and impact of using the PROMETHEUS Payment model, a novel, episode-based payment system. The purpose of this project is to simulate the payment changes under PROMETHEUS to estimate the effect of the model on total spending and provider revenue, improvements in efficiency, reductions in complications, etc. This application of PROMETHEUS algorithms to actual participant billing data will help identify the prerequisites for providers and payers to succeed under this model, the need for changes to the model, and the likely effect on cost and quality of care. The project will also conduct analysis of post-intervention data from one or more pilot sites to examine actual payments and complication rates.